Role of UK chief medical officer has been eroded

BMJ 1998; 317 doi: (Published 14 November 1998) Cite this as: BMJ 1998;317:1340
  1. John Warden, parliamentary correspondent
  1. BMJ

    An inside view on how the post of chief medical officer for England has been diminished in recent years has come from a former incumbent, Sir Donald Acheson, chief medical officer from 1983 to 1991. He stated last week–while presenting evidence to the official inquiry into bovine spongiform encephalopathy–that his successors have been penalised and their independence compromised by staff cuts and restructuring in the Department of Health.

    Sir Donald explained that from its creation in 1919 until after he left, the department consisted of two parallel hierarchies, medical and administrative. As the person managerially accountable for the medical staff, the chief medical officer was responsible for the quality of the medical advice within the department. In the subsequent integration of the department, Sir Donald understood that the chief medical officer had been left with hardly any staff for whom he is accountable. He added: “It is difficult to see how this responsibility can be discharged effectively or indeed how he could successfully insist, against opposition, on any necessary changes to address new problems or emergencies. This is, I believe, a unique penalty for a person working at this level of responsibility, whether in the public or the private sector, and risks compromising the independence of the chief medical officer, which is so important to the protection and improvement of health in this country.”

    Sir Donald estimated that during his years in office he had to spend at least 20% to 25% of his time resisting “incessant” cuts in his staff. Asked if this impeded the work on BSE, Sir Donald said that it did not because of the top priority he gave to it, although it could have meant that other areas suffered. Confronted with a televised recording in which he had said “there is no risk associated with eating British beef,” Sir Donald admitted that he should not have said it because the expert advice he was getting was that there was a remote risk

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